MEDICARE: C AND I INTERNATIONAL INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0003X	Community/Retail Pharmacy	27840	TX

General Provider Information

NPI Number	:	1659658110
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	C AND I INTERNATIONAL INC.

Provider Business Mailing Address
First Line	:	4308 NICHOLAS CT
Second Line	:
City	:	GRAND PRAIRIE
State	:	TX
Zip	:	75052-4846
Country	:	US
Telephone Number	:	214-437-5408
Fax Number	:	972-264-9859

Provider Business Practice Location Address
First Line	:	1321 N COCKRELL HILL RD
Second Line	:	SUITE 101A
City	:	DALLAS
State	:	TX
Zip	:	75211-1314
Country	:	US
Telephone Number	:	469-567-3654
Fax Number	:	469-567-3655

Authorized Official
Title or Position	:	PHARMACIST IN CHARGE
Name	:	CHINEDUM EGUZOUWA
Credential	:
Telephone Number	:	214-437-5408

Provider Enumeration Date	:	11/11/2011
Last Update Date	:	05/31/2013

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